Nature & Nurture #151: Dr. Michael Bernstein - The Placebo & Nocebo Effects

Dr. Michael Bernstein is an experimental psychologist, Assistant Professor

at Brown University Medical School, and the author of The Nocebo Effect: When Words Make You Sick. Dr. Bernstein’s research is focused on the overlap between cognitive science and medicine, studying the role of expectation in healthcare and leveraging the placebo effect to improve patient outcomes. 

In this episode, we explore the mechanisms, implications, and ethical dilemmas of the placebo and nocebo effects in healthcare. Dr. Bernstein explains that the nocebo effect is essentially the opposite of the placebo effect, where negative expectations can lead to worsening symptoms. He shares examples from randomized trials and addresses ethical challenges in medical disclosure. We also discuss the impact of patient expectancy, anxiety, and media influence on symptom manifestation, along with considerations for future research and practical applications in medicine.

00:27 Understanding the Nocebo Effect

02:11 Ethical Dilemmas in Medical Disclosure

04:38 The WebMD Effect and Media Influence

08:20 Psychological Mechanisms of Nocebo and Placebo

17:28 Conditioning and Expectation in Healthcare

18:34 Evolutionary Perspectives on Placebo

23:16 Trust, Authority, and the Placebo Effect

29:04 Understanding Negativity Bias in Behavioral Economics

29:46 Environmental Factors and Nocebo Effects

31:54 Recency Bias in Medical Procedures

33:47 The Role of Cognitive Biases in Healthcare

35:46 The Placebo Effect in Surgeries

43:24 AI in Medicine: Ethical Considerations and Future Directions

51:52 Open Label Placebos and Pain Management

53:44 The Importance of Ritual in Healing

55:30 Exploring Placebo Effects in Animals